As The Baby Boomers Age

As the generation that made the Sexual Revolution gets older, they are causing us to confront all kinds of icky things. Such as:

At 8:30 p.m. on Christmas Day 2009, nurse Tiffany Gourley was called to a room at theWindmill Manor nursing home in Coralville, Iowa. She found a 78-year-old male resident who had just had intercourse with an 87-year-old woman. The man, a former college professor, was divorced. The woman, a retired secretary, was married. Both had dementia.

What followed illustrates one of the most complex and unexamined issues facing elderly care facilities as the Baby Boom generation enters old age: How to determine if residents with dementia have the mental capacity to consent to sex.

The Windmill Manor incident and its lengthy aftermath also show that nursing homes, regulators and families are not prepared to deal with that question.

Who is? Robin Dessel, that’s who:

Some facilities, such as the Hebrew Home at Riverdale, New York, presume that residents with dementia have the capacity to decide whether to have sex. The 870-resident home has had a written policy on sexual expression since 1995.

“Yes, we need to make Solomon’s decisions at times, but we need to err on the side of what the resident wants,” said Robin Dessel, the Hebrew Home’s sexual rights educator. “Relationships are totally personal matters of the heart.”

What kind of old folks’ home has a “sexual rights educator”? Could there be a more Baby Boomer-ish job than sexual rights educator at a nursing home?

I kid, but if you read the Bloomberg story, you’ll see that two people in management at the nursing home lost their jobs and had their careers ruined because people aren’t quite sure how to deal with this issue.

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36 Responses to As The Baby Boomers Age

That’s OK, Rod, people our age (I’m just five years older than you are) won’t be going into nursing homes, because there won’t be any money left to fund things like that for most of us by the time we get to that point.

I strongly suspect you will decide your tallywhacker, old or not, is a desirable companion all the way to your deathbed.

Either that, or you will decide that you only approach “real” old age asymptotically; getting ever closer but never getting quite there.

[NFR: I hope not. If I have to worry about being senile and randy, and rutting with fellow prunes, then I hope I can just detach the damn thing and leave it at the desk when I check into the nursing home. — RD]

I wonder how much of this is actually due to the Baby Boomer generation and how much is due to people simply being physically healthier later in life.

I wonder, too, if this is the sort of thing also comes out a great deal more because we’re far more likely to place people in a nursing home where they’re more likely to meet someone of eligible age, in a public setting where we’re more likely to notice the goings on.

The one area where the sexual revolution has made a discernible difference is that these questions are now actually getting aired, rather than being hidden away as private or embarrassing. To make an analogy, I doubt that the molestation scandal in the Catholic Church could possibly have happened without the sexual revolution; families of victims and victims themselves would have been unwilling to speak out.

The idea that the elderly are sexual beings too, just like any other adults, is a truth many of us prefer not to face. It’s hard enough discovering that our parents are sexual beings, but our grandparents? But it’s always been true. Otherwise, why the heck have rich old men always taken young, vivacious wives, a practice as common in medieval times as in the age of Anna Nicole Smith?

And the question of whether people with dementia can give consent is an important question that needs an answer. Sex isn’t something reserved for the young and beautiful.

I’d say 1935 and 1926 are a bit old to be paragons of the baby boom. They probably had kids who were baby boomers. This just goes to show that those who think their generation (or the one before or after them) invented sex, invented licentiousness, invented free love, etc. etc. etc. don’t know what they’re talking about.

I think Miss Manners once wrote something to the effect of, look, I know there are people who think sex was invented in Berkeley, California in 1963 by a couple of graduate students and a supervising professor who insisted on duplicating the research, but I know that sex has been with us much longer than that, because I happen to be descended on both sides of my family from people who practiced it.

That said, there are only two or three ways for nursing homes to deal with this stuff:

1) Yes, residents can make their own decisions, demented or not,

2) No, residents may not have sex unless they are sharing a room with someone they were married to before they arrived,

3) Its up to their kids to decide (and we all know kids can be petty tyrants or just plain wrong quite as often as their demented parents can be),

4) Each nursing home will have a sexual autonomy dementia quotient formula to determine whether residents can make such decisions or not.

Firing people over this sounds like a craven CYA move by higher-ups. There is no way anyone could have been expected to be on top of this before it came up.

I don’t plan to ever enter a nursing home anyway. I’ll roll myself down a hill into a river first.

I think that the wishes of the individual before they got dementia should be weighed heavily–you could have a sort of living will for this sort of situation. Sample phrasing: “I value my marriage vows and I do not wish to commit adultery in the nursing home.”

Rod–what compels you to read these things and then share them with us, your loyal readers? Some days you remind me of the cat that kept dragging live rats into the house. Sometimes it is just better to avert your eyes.

[NFR: Every day I get lots of email from readers sending links, and saying, “Dreher bait!” Sometimes I just can’t help biting. — RD]

If they truly have dementia, they have no ability to consent to such things. I once worked with an organization that looked after mentally handicapped and that organization had a similar policy, but commonsense dictated such things in actual practice among the workers. I’m sorry, but the workers are the ones who have to put up with the results of the actions of the residents who cannot consent, cannot make a moral decision. In saner times, folks would simply not let this happen. End of story.

Also, simple decency and modesty would prevent such things, i.e. separate living quarters for men and women.

Indeed, I was once present when someone asked the poet Sophocles: “How are you as far as sex goes, Sophocles? Can you still make love with a woman?” “Quiet, man,” the poet replied, “I am very glad to have escaped from all that, like a slave who has escaped from a tyrannical master.”

Incidentally, the more modern translations are more faithful to the Greek. If in your youth you only read the tiresome old translations of the Victorian era, you missed some of the funniest bits.

Rod, Rod, Rod. My successor will not have the title Pope, his title will be Panarch and the succession will be settled in a civilized manner. The contenders will fight to the death and the one left alive at the end gets the title. None of this namby-pamby business of voting.

Oh and as next Monday is the Feast of St. Rasputin followed by the Feast of St. Conrad of Marburg the next day, the good Cosimanian Orthodox will be too busy celebrating to worry much about such future details.

I would say that in general, nursing home staff aren’t probably qualified to answer questions of consent–this ought to be the province of the patient, family members and doctors and such. (Generally, if the patient can vocally insist on his/her right to consent, there should be a presumption in favor of such, absent compelling information to the contrary. Patients unable to communicate consent, for whatever reason, should be assumed to be incapable of giving it).

On the plus side–one of the major risks of unprotected intercourse–unwanted pregnancy–is typically not a problem for nursing home patients.

That said, I suspect a bigger problem in nursing homes (and hospitals, rehab clinics, group homes, and other such facilities) is sexual abuse of patients by staff and visitors, not by other patients. (And encounters between two patients who neither of which are consent-capable, seems analogous to encounters between minors; a matter for guardians, perhaps, but not for the law).

The good news is that most people don’t become that mentally compromised. I also agree that consent in such cases comes to trying to figure out what the person would do if they had their faculties intact.

You’re late to the game, Rod. I learned about this stuff in my sociology of aging course 5 years ago! There’s a bit of a problem with the eldery getting STD’s.

One of my friends used to work in a nursing home. She opened a door, and discovered an old woman giving an old man a bj. She yelled “SORRY”, closed the door, and told me later that it’s good to know that she’ll still be up for some fun with her hubby in her elder years. 🙂

“Windmill Manor, 2332 Liberty Drive in Coralville, has posted the poorest ratings of any Iowa City area nursing home over the past three years. Looking at the past 7 biannual periods, plus the current rating, the facility received an overall one-star rating six times, and twice received a two-star rating.

Though Windmill Manor has more beds than any other area nursing home, its occupancy rate is well below half — just 49 of 120 beds were filled, according to a 2011 count.

Between November 2010 and January 2012, Windmill Manor had 33 health violations, according to the Centers for Medicare and Medicaid Services. The average number of health deficiencies at Iowa nursing homes in that period was seven, and the national average was eight.

The Iowa Department of Inspections and Appeals’ annual survey at the facility turned up a dozen violations in January, including instances in which the nursing home failed to take appropriate measures to prevent falls, complete thorough incontinence and oral care for certain residents, reposition a resident with pressure sores, protect food from contamination and properly store medications.

The state also investigated health complaints in December 2011, and found that Windmill Manor failed to provide an adequate supply of clean linens for several residents, neglected to follow a physician’s order for a resident, and found no documentation disproving a resident’s complaint that he or she had not been given a shower in more than a week.

The state has fined Windmill Manor three times this fiscal year for a total of $9,000, said David Werning, public information officer for the Iowa Department of Inspections and Appeals. That included an $8,000 penalty for failing to follow a physician’s orders to change the dressing and monitor the skin of a resident who was admitted with a broken arm, resulting in an infection that required a surgery and six weeks of intravenous antibiotics.

Those recent issues, however, are less severe than problems that came to light in 2010 at the nursing home. Windmill Manor was initially slapped with hefty state and federal fines when accusations arose of management attempting to cover up the sexual abuse of an elderly female resident by a fellow resident in 2009. The facility’s director of nursing stood trial, but was found not guilty of a charge of impeding an inspection.

Last month the Iowa Board of Nursing Home Administrators charged Steve Drobot, who served as the administrator of Windmill Manor from December 2008 to March 2010, with professional incompetence, negligence and violating nursing home regulations stemming from the 2009 issues. A disciplinary hearing is scheduled for April 12 in Des Moines.

The nursing home ended up paying $14,500 to the state and $7,930 to the federal government in fines as a result of the investigation. But according to Werning, Windmill Manor remains in “substantial compliance with state and federal rules and regulations.””

The mismanagement at that facility is well known, which is why it is at under 50 percent capacity, and will remain so for a long, long time.

The problem is widespread, and apparently has been so for a number of years.

he Elba Police Department responded to the Elba Nursing Home on Tuesday, July 2 after they received a complaint of sexual assault.

Norman Spence Daniels, 63, was arrested after an initial investigation by police. According to a press release from the Elba Police Department, Daniels sexually assaulted another resident at the facility. He was charged with sexual abuse in the first degree.

Columbus police detectives are investigating claims from three nursing home patients who say they were sexually assaulted.

Officials at River Towne Center on Warm Springs Road said none of their employees are accused of the crimes. The three female patients are alleging that two male patients at the facility perpetrated these acts on separate occasions.

The crimes were reported to police Friday and occurred at unknown times in the past.

You have to wonder, with the number of cases of abuse reported in the past ten years, how long will it take these nursing homes to actually develop policies to deal with it?

My wife worked in an assisted-care home for seniors for about 10 years…. she has some hilarious/disturbing stories about the sort of sexual hi-jinxs that would go on between not only the residents, but between the residents and staff… nothing actually criminal like staff abusing residents, more like supposedly “senile” old men trying to cop a feel on her, or exposing themselves, talking dirty, etc.

This is a disturbing article. As is increasingly the case in these episodes, consent is the only rock left for a secularists to stand on for judging their actions. And this article reveals even that rock has a crack or two in it.

It was disturbing while reading this that none of the people offering their professional opinion felt strongly (I believe it was only mentioned in passing) that they had a real obligation to help someone with dementia maintain their marriage vow. It all just sounded so clinical, detached from human experience. This article – especially the parts describing what happened and what it means – would have only been written slightly more clinically if it was about the animals at the humane society.

I’m fairly sympathetic to the two peoplewho lost their jobs – they are supposed to (apparently) enforce quasi-traditional sexual ethics in a secular world where consent is the only guiding tool, putting them in a rather impossible situation.

Old people having sex–disgusting! Unless, of course, you’re a Biblical patriarch on a mission from God: see Genesis 17 & 18. (I note, on rereading this text, that while God rebuked Sarah for her laughter–18:13–he didn’t seem to mind a bit that Abraham literally fell on his face with laughter–17:17–at the prospect of fathering a child at the ripe old age of 100.)

People aged 78-87 are not Baby Boomers. They’re either Silent Generation (children or teens during WW II) or Greatest Generation (who experienced WW II as adults.)

I thought they were supposed to be the “moral” ones.

Anyway, non-demented people who are old can consent to sex just fine, even if they are living in nursing homes.

Finally, reiterating the loathsomeness of old people sex doesn’t sound very good either for one’s mental health or one’s marriage. Because those who don’t trade their spouses in for younger models end up having sex with an old person. Shock. Horror. I know, the humanity.

“Indeed, I was once present when someone asked the poet Sophocles: “How are you as far as sex goes, Sophocles? Can you still make love with a woman?” “Quiet, man,” the poet replied, “I am very glad to have escaped from all that, like a slave who has escaped from a tyrannical master.””

I read that some other Greek philosopher or poet was asked “At what age does a man stop being interested in sex?” and answered “When I find out, I’ll let you know.”

“I’m fairly sympathetic to the two peoplewho lost their jobs – they are supposed to (apparently) enforce quasi-traditional sexual ethics in a secular world where consent is the only guiding tool, putting them in a rather impossible situation.”

“According to the Iowa Department of Inspections and Appeals , director of nursing Karen Etter reportedly threatened staff members not to tell anyone about the incident if they wanted to keep their jobs. One worker told inspectors that she was instructed not to report the incident to the head of the dementia unit because the facility could face a fine from state inspectors. That same employee felt that the attitude of her boss was such that she could be fired for reporting.

Iowa law requires caregivers to report all suspected abuse. The Christmas Day incident went unreported to the state, although the male resident’s physician ordered medication for him to decrease his sex drive.

Etter is no stranger to problems with the state. In March, the State of Iowa alleged that she threatened seven employees if they reported quality of care concerns.”

“According to state officials, Etter freely admitted telling employees of the home that they’d be fired if they reported quality-of-care concerns directly to state inspectors, rather then reporting them to her, the administrator or the home’s corporate owners.

At her trial, three of Etter’s co-workers testified that she had told the staff she had “a stack of applications” from prospective employees who were eager to take their jobs. Etter did not testify at the trial. Magistrate Karen Egerton ruled that although Etter’s management style was harsh, unprofessional and “tyrannical,” she had not actually interfered with a state investigation. Egerton noted that when Etter threatened to fire the workers, there was no pending state investigation into wrongdoing at the home.”

Thank goodness she had covered things up well enough to prevent the state from starting its investigation earlier, otherwise her threats would have been against the law!

I just love the way Bloomberg reporters and others cherry pick the news to spin things to support their preconceived agenda. You’d think that folks who accuse liberals of doing the same would be more careful to report the facts and not simply set their spin cycle to permanent press.

But please, carry on with your lament of how this poor woman was so mistreated for wanting to enforce “quasi-traditional sexual ethics”. Don’t let facts get in your way.

The contenders will fight to the death and the one left alive at the end gets the title.

Charles Cosimano meets “The Hunger Games.”

Not too long ago there was a bit of a scandal at the Milwaukee county mental health facility, over several rapes by male patients of female patients. One administrator (who did lose his job, and rightly so), said that was an acceptable price to avoid the high level of violence breaking out between male patients when patients were segregated by sex.

Of course, as our semantical jurists making the case for mandatory SSM remind us, it is wrong to EVER make ANY distinction on the basis of sex, as if men and women were in any way different from each other.

@Josh McGee – The problem is that when you have a message you wish to deliver (that the bad baby boomers are sex crazed monsters out to destroy our institutions), you tend to filter everything through that. In this instance the Bloomberg story cast the two administrators as poor, oppressed folk who were fired for trying to enforce old-fashioned moral concepts, and in doing so were met with the nasty boomer attitudes about sex.

Setting aside the fact that the two residents were too old to be considered boomers by any rational measure, the story overlooked the fact that just a year prior to the Christmas 2009 incident there was yet another instance in the Alzheimer’s unit with two residents caught in bed in compromising positions. These two administrators successfully swept that under the rug by their threats and deception to the state (thus the charges of persistent mismanagement after the 2009 incident).

Sexual assault is a real problem in our nursing homes. Just do a search on the topic and hundreds of hits from all over the country pop up. But in this particular instance the Bloomberg story did a terrible disservice to the issue by painting incompetent administrators in the most sympathetic light. Essentially the story contributed to the problem by going soft on the administrators.

But, it did a good job of promoting the meme of the nasty old, sex-crazed boomers.

Richard Johnson is on to something here… this isn’t a shocking new development, and its not something that relevant authorities are incapable of dealing with, or haven’t been dealing with, but violations do occur, and it takes some time and effort to get them under control.

When it comes to sexual responses of adults with advanced senile dementia, we might consider that sexual emotions evolved so that large clumsy animals utterly lacking in advanced human cognition would engage in precisely this sort of behavior. Thus, it is almost natural that it would occur between adults with senile dementia.

That may mean no more than, so adults with senile dementia need to be segregated by sex.

Of course, as our semantical jurists making the case for mandatory SSM remind us, it is wrong to EVER make ANY distinction on the basis of sex, as if men and women were in any way different from each other.

Oh, horsepuckey.

This sounds like the anti-ERA arguments from the 70s that if the Equal Rights Amendment passes, men and women would be forced to share sexually-integrated public restrooms and locker rooms.

And nobody is arguing for mandatory SSM (which to me sounds like, “you WILL marry another man, like it or not”); nor does that issue eliminate all distinctions between men and women in contexts other than the marriage registrar’s office.

This sounds like the anti-ERA arguments from the 70s that if the Equal Rights Amendment passes, men and women would be forced to share sexually-integrated public restrooms and locker rooms.

Engineer Scotty, my friend and sometimes ally, you really should stop pulling boogie-men out of your anxiety closet and pasting them onto the face of whoever you happen to find yourself arguing with.

The ERA foundered, in large part, because it was SO broad in its wording that any court might well have interpreted it to mandate the absurdities you so blithely dismiss. That was a reason to think carefully in drafting legal language, not to dismiss the notion of women’s equality as citizens. One should never draft laws or constitutional language in the blithe confidence that no court would ever apply it in manner that violates common sense, particularly when the violation of common sense fully accords with the plain meaning of the words.

Nor did I say anything about mandatory SSM. I was simply responding to the line of semantical manipulation which asserts that marriage laws have NOTHING to do with sex. Some people have resorted to that extremity, to avoid the possibility that marriage laws are at attempt to license, regulate, and tax, the union of male and female. If they are, then there may be no constitutional reason why such laws MUST license, regulate and tax any other human relationship whatsoever.

Fair enough. I would disagree that the phrase “Equality of rights under the law shall not be denied or abridged by the United States or by any State on account of sex” permits such a broad reading as requiring co-ed restroom facilities (though I could see a plethora of lawsuits on the proper ratio of toilets in men’s and women’s restrooms, given men’s inherent ability to do #1 more quickly), and consider such claims to be offered in bad faith. (The claims made by ERA opponents, not anything you have said). Some of the other claims or ERA opponents–such as female infantry in the Army–have practically come to pass regardless. But then again, the ERA is dead and buried.

That said, my main point is–most SSM supporters, including myself, do NOT suggest that no distinction between genders may be made. “Gender erasure” remains soemthing that is mainly the province of the postmodern left (and silly college students), not anything with mainstream political support. (We can do a better job of accommodating transgendered people, of course, but that does not require pretending gender does not exist).

Obviously, marriage laws have something to do with sex–though as many have pointed out, far less than they used to. Marriage is no longer a legal prerequisite for intercourse or other sexual relations; fornication laws being unenforceable. Annulment for non-consummation is a rarity. Marital rape is now illegal. Broadly-available adoption and various medical advances make marriage (or even intercourse) no longer necessary for raising a child. One area where marriage still DOES affect sex is the question of adultery–a partner has a legal claim against a cheating spouse (though only in the context of divorce court); I see no reason, though, that this can’t apply to same-sex partners as well.